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Introduction : This pilot study examined access to telemedicine-related opioid use disorder (OUD) treatment in underserved communities in Houston, Texas before July 30, 2023. Methods : Participants, both patients and providers, were recruited in partnership with local substance use treatment clinics. Both groups shared experiences before and after the waiver era. Rapid qualitative analysis was conducted by the research team. Results : Fourteen qualitative interviews were conducted via Zoom with 5 treatment providers and 9 self-identified Black or Hispanic patient participants. Participants generally approved telemedicine for OUD treatment due to its technological accessibility and flexibility. However, concerns about technology, care quality, relationship building, and privacy were common among both patients and providers. Discussion : Our study highlights the underutilization of telemedicine for OUD treatment in underserved Houston communities. Efforts to address current limitations and leverage recent policy changes can help bridge the utilization gap in underserved areas.

Background: ChatGPT is the most advanced large language model to date, with prior iterations having passed medical licensing examinations, providing clinical decision support, and improved diagnostics. Although limited, past studies of ChatGPT's performance found that artificial intelligence could pass the American Heart Association's advanced cardiovascular life support (ACLS) examinations with modifications. ChatGPT's accuracy has not been studied in more complex clinical scenarios. As heart disease and cardiac arrest remain leading causes of morbidity and mortality in the United States, finding technologies that help increase adherence to ACLS algorithms, which improves survival outcomes, is critical., Objective: This study aims to examine the accuracy of ChatGPT in following ACLS guidelines for bradycardia and cardiac arrest., Methods: We evaluated the accuracy of ChatGPT's responses to 2 simulations based on the 2020 American Heart Association ACLS guidelines with 3 primary outcomes of interest: the mean individual step accuracy, the accuracy score per simulation attempt, and the accuracy score for each algorithm. For each simulation step, ChatGPT was scored for correctness (1 point) or incorrectness (0 points). Each simulation was conducted 20 times., Results: ChatGPT's median accuracy for each step was 85% (IQR 40%-100%) for cardiac arrest and 30% (IQR 13%-81%) for bradycardia. ChatGPT's median accuracy over 20 simulation attempts for cardiac arrest was 69% (IQR 67%-74%) and for bradycardia was 42% (IQR 33%-50%). We found that ChatGPT's outputs varied despite consistent input, the same actions were persistently missed, repetitive overemphasis hindered guidance, and erroneous medication information was presented., Conclusions: This study highlights the need for consistent and reliable guidance to prevent potential medical errors and optimize the application of ChatGPT to enhance its reliability and effectiveness in clinical practice., (©Cecilia Pham, Romi Govender, Salik Tehami, Summer Chavez, Omolola E Adepoju, Winston Liaw. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 22.04.2024.)

By 2050, one in five Americans will be 65 years and older. The growing proportion of older adults in the U.S. population has implications for many aspects of health including disaster preparedness. This study assessed correlates of disaster preparedness among community-dwelling minority older adults and explored unique differences for African American and Hispanic older adults. An electronic survey was disseminated to older minority adults 55+, between November 2020 and January 2021 ( n = 522). An empirical framework was used to contextualize 12 disaster-related activities into survival an0000000d planning actions. Multivariate logistic regression models were stratified by race/ethnicity to examine the correlates of survival and planning actions in African American and Hispanic older adults, separately. We found that approximately 6 in 10 older minority adults did not perceive themselves to be disaster prepared. Medicare coverage was positively associated with survival and planning actions. Income level and prior experience with disaster were related to survival actions in the African American population. In conclusion, recognizing the gaps in disaster-preparedness in elderly minority communities can inform culturally sensitive interventions to improve disaster preparedness and recovery.

Objective: Evidence suggests that people of color, especially African Americans and non-White Hispanics, residing in low-income communities are the most vulnerable to natural disasters. This study assessed individual level of self-perceived disaster preparedness, disaster response actions, and sociodemographic predictors of disaster preparedness among older minority adults in Houston, Texas., Method: Working with Houston-area community-based organizations and senior-living centers, a cross-sectional survey, available in English and Spanish, was disseminated between November 2020 and January 2021., Participants: Five hundred and twenty-two older minority adults aged 55+ completed the electronic survey., Main Outcome Measure(s): The main outcome measure was the level of self-perceived preparedness regarding emergencies and disastersie, prepared vs not prepared-among the study participants., Results: Overall, about 58 percent of older minority adults did not perceive themselves to be prepared. Compared to individuals reporting annual incomes below $25,000, individuals reporting annual incomes between $25,000 and $74,999 were more likely to report being prepared [odds ratio (OR) = 2.28, 95 percent confidence interval (CI) = 1.29, 4.05]. Individuals who tested positive or had a close family member test positive for COVID-19 experienced 2.16 times higher odds of having self-perceived disaster preparedness than those who did not [OR = 2.16, 95 percent CI = 1.37, 3.42]. None of the other covariates were statistically significant., Conclusions: While we observed no differences in self-perceived disaster preparedness between African American and Hispanic older adults, our findings suggest the importance of prior experience/exposure to previous disasters and the role of socioeconomic status in self-perceived disaster preparedness in minority older adults.